Double-blind randomized placebo-controlled study of bixa orellana in patients with lower urinary tract symptoms associated to benign prostatic hyperplasia

OBJECTIVE: To determine the efficacy of Bixa Orellana (BO) in patients with benign prostatic hyperplasia (BPH) presenting moderate lower urinary tract symptoms (LUTS). MATERIALS AND METHODS: It is a prospective double-blind randomized placebo-controlled study. One thousand four hundred and seventy eight patients presenting moderate LUTS associated to BPH were interviewed, from whom we selected 136 to fulfill the criteria of inclusion and exclusion. Assignation was performed at random in blocks of four to receive B0 at a dose of 250 mg 3 times a day or placebo (Pbo) for 12 months, 68 patients were assigned to each group. From the patients in the study we obtained data of demographic, epidemiologic, symptom score, uroflowmetry and post void residual urine variables. RESULTS: Basically both groups were compared clinically, demographically and biochemically. Throughout the study variations of symptom score, mean delta symptom score during each visit and the final average delta were similar for both groups (BO - 0.79 ± 1.87 and Pbo - 1.07 ± 1.49) (p = 0.33). Similarly variations of Qmax mean, Qmax average delta and final average delta were similar (BO 0.44 ± 1.07 and Pbo 0.47 ± 1.32) (p = 0.88). Variations of post void residual urine mean, post void residual urine average delta in each visit and the final average delta were similar for both groups (BO 4.24 ± 11.69 and Pbo 9.01 ± 18.66) (p = 0.07). No differences were found in the answers of clinically significant improvement assessed with relative risk and risk differences, even though the proportion of adverse effects was similar for both groups. CONCLUSION: Patients with BPH that present moderate LUTS did not show any benefit receiving BO when compared to placebo.

Estudo populacional de triagem visual e intervençäo cirúrgica para reduzir a cegueira por catarata em Campinas-Brasil e Chimbote-Peru / Populational study on visual selection and surgical intervention to reduce the blindness caused by cataract in Campinas-Brasil and Chimbote-Peru

Dois projetos, um no Brasil e outro no Peru, foram elaborados para proporcionar cirurgia para todos os casos de cegueira por catarata vivendo em um área definida. A triagem domiciliar de acuidade visual foi aceita por três quartos da populaçäo enumerada com 50 anos ou mais. Aqueles com baixa acuidade visual bilateral foram encaminhados para um posto de saúde comunitário para exame oftalmológico. Dentre os diagnósticados como cegos bilaterais (AV menor ou igual a 20/200), compreendendo 5% da populaçäo triada, dois terços eram devido a catarata. Por causa de outras patologias oculares e más condiçöes gerais de saúde, a cirurgia näo foi indicada em 30% a 50% dos casos. Dois terços daqueles com indicaçäo para cirurgia ambulatorial aceitaram cirurgia. Foram feitas tentativas para motivar os casos de recusa, sempre sem sucesso. A idade média dos que aceitaram e dos que recusaram era ao redor de 75 anos. Os casos já afácicos encontrados eram de 7 a 8 anos mais jovens. A acuidade visual no seguimento pós-operatório foi menor ou igual a 20/50 para metade dos operados. Um número significativo de casos tinha degeneraçäo macular senil ou outras causas de baixa visäo näo detectados previamente